Key Medicare Changes in 2024: What Beneficiaries Need to Know

Medicare, the U.S. federal health insurance program primarily for individuals aged 65 and older, undergoes annual adjustments to its coverage, costs, and policies. For 2024, several significant changes have been implemented that affect beneficiaries. Here's an overview of the key updates:

1. Adjustments in Premiums and Deductibles

• Medicare Part A (Hospital Insurance):
• Premiums: Most beneficiaries receive Part A without a premium. However, those who do not qualify for premium-free Part A will see an increase. In 2024, the maximum monthly premium rises to $505, up from $499 in 2023.
• Deductible: The inpatient hospital deductible increases by $32, bringing it to $1,632 per benefit period. Centers for Medicare & Medicaid Services
• Medicare Part B (Medical Insurance):
• Premiums: The standard monthly premium for Part B is set at $174.70 in 2024, reflecting a $9.80 increase from the previous year.
• Deductible: The annual deductible for Part B rises to $240, a $14 increase from 2023. Centers for Medicare & Medicaid Services

2. Enhancements in Prescription Drug Coverage (Part D)

• Elimination of Catastrophic Phase Cost-Sharing: Starting in 2024, beneficiaries who reach the catastrophic coverage phase will no longer be required to pay the 5% coinsurance. This change effectively caps out-of-pocket spending for Part D enrollees.
• KFF
• Expansion of the Low-Income Subsidy (LIS) Program: The Inflation Reduction Act expands eligibility for the full low-income subsidy to individuals with incomes up to 150% of the federal poverty level. This expansion aims to assist approximately 300,000 low-income individuals with Medicare in accessing affordable prescription drug coverage.
• Centers for Medicare & Medicaid Services

3. Medicare Advantage (Part C) Updates

• Premium Stability: The average monthly premium for Medicare Advantage plans is projected to increase slightly from $17.86 in 2023 to $18.50 in 2024. Notably, nearly 73% of enrollees are expected to experience little or no premium increase.
• Centers for Medicare & Medicaid Services
• Enhanced Behavioral Health Access: New regulations require Medicare Advantage organizations to improve access to behavioral health services. This includes adding clinical psychologists and licensed clinical social workers to their networks and ensuring timely access to these services.
• Centers for Medicare & Medicaid Services

4. Policy Changes and Beneficiary Protections

• Prior Authorization Reforms: The Centers for Medicare & Medicaid Services (CMS) has implemented measures to streamline the prior authorization process in Medicare Advantage plans. These changes aim to reduce delays and ensure timely access to necessary services for beneficiaries.
• Centers for Medicare & Medicaid Services
• Emphasis on Health Equity: Medicare Advantage organizations are now required to include providers' cultural and linguistic capabilities in their directories. Additionally, they must implement quality improvement programs focused on reducing disparities in care.
• Centers for Medicare & Medicaid Services

5. Future Outlook: Upcoming Changes in 2025

Looking ahead, significant changes are slated for 2025, including the introduction of a $2,000 out-of-pocket spending cap for Part D enrollees and the elimination of the coverage gap phase. These reforms aim to further reduce prescription drug costs for beneficiaries.

KFF

Conclusion

The 2024 updates to Medicare reflect ongoing efforts to enhance coverage, control costs, and improve access to essential health services for beneficiaries. Staying informed about these changes is crucial for making the most of Medicare benefits and ensuring optimal health care outcomes.

Sources:

• Centers for Medicare & Medicaid Services (CMS) – 2024 Medicare Parts A & B Premiums and Deductibles
• Kaiser Family Foundation (KFF) – Changes to Medicare Part D in 2024 and 2025 Under the Inflation Reduction Act
• CMS – 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F)
• CMS – Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable in 2024